計算

HEART Score for Major Adverse Cardiac Event

Estimates short‑term risk of major adverse cardiac events in patients with chest pain.

(H)istory

None-Slightly Suspicious0Moderately Suspicious+1Highly Suspicious+2

(E)KG

Normal0Non-specific Repol. Abnorm.+1Significant ST-Depression+2

(A)ge

45 years old or younger046-64 years old+165 years old or older+2

(R)isk Factors

No Risk Factors01-2 Risk Factors+13 or more Risk Factors or atherosclerosis history+2

(T)roponin

Normal Limit or Less01-3 times Normal Limit+13 times or more than Normal Limit+2

使用適応

Used in ED patients with possible ACS, nonischemic ECG, and initial/serial troponin available, to rapidly stratify 30‑day MACE risk and guide discharge vs. further testing. A score ≤3 identifies low‑risk patients who may be safely discharged when combined with negative troponins, with ~0.4% 30‑day death/MI in implementation studies 1 [Level I evidence]. A score ≥4 supports observation, additional testing, or admission.

洞察と注意事項

Identifies low risk reliably only with score ≤3 plus nonischemic ECG and negative serial troponin, yielding ~0.4% 30‑day MACE in implementation data 1 [Level II evidence]. Cautions: subjective history weighting; reduced specificity in older adults; not a diagnostic tool; may miss late presenters with flat troponin trends. High scores (≥7) markedly increase ACS probability 2 [Level II evidence]. Use only alongside hs‑cTn pathways and clinical judgment.

HEART Score for Major Adverse Cardiac Event - 医学計算ツール - Vera